Clinical Advances in Periodontics最新文献

{"title":"10-year follow-up of adolescent leukemia diagnosed through gingiva: A case report.","authors":"Gang Yang, Yuan Tu, Wenjie Hu, Xianghui Feng","doi":"10.1002/cap.10340","DOIUrl":"https://doi.org/10.1002/cap.10340","url":null,"abstract":"<p><strong>Background: </strong>Systemic diseases often present initial signs through oral manifestations, making early recognition essential for accurate diagnosis and effective treatment planning. Patients with acute lymphoblastic leukemia (ALL) commonly experience gingival issues. This case report discusses the treatment and outcomes of a 12-year-old female patient who presented with gingival swelling and pain and was subsequently diagnosed with ALL.</p><p><strong>Methods: </strong>The patient underwent chemotherapy and basic periodontal supragingival scaling. Comprehensive clinical assessments, oral photographs, and imaging data were recorded at the initial visit, and at follow-ups 8 years and 10 years later.</p><p><strong>Results: </strong>A routine blood test and bone marrow aspiration confirmed a diagnosis of B-cell acute lymphoblastic leukemia (B-cell ALL). After 1 year of chemotherapy with rituximab, the patient recovered and was discharged. An 8-year follow-up revealed significant clinical attachment gain and healthy gingival status, and complete recovery was observed at a 10-year follow-up.</p><p><strong>Conclusions: </strong>Adolescents presenting with swollen and bleeding gums should be evaluated for potential leukemia. Dentists, especially periodontists, should be aware of the oral manifestations of ALL and coordinate with medical professionals to establish a comprehensive, long-term treatment plan. Periodontal health in adolescents with ALL can improve significantly with leukemia remission and appropriate basic periodontal therapy.</p><p><strong>Key points: </strong>Oral manifestations as early indicators: In adolescents with acute lymphoblastic leukemia (ALL), systemic symptoms may be minimal or absent. Early recognition of oral changes, such as gingival swelling or bleeding, is crucial for timely diagnosis. Long-term periodontal recovery: A 10-year follow-up indicates that periodontal health can improve following leukemia treatment and basic periodontal therapy, although longer follow-up is recommended to assess the stability of recovery.</p><p><strong>Plain language summary: </strong>It is challenging to recognize systemic diseases early through oral manifestations in adolescents, which is critical for accurate diagnosis. Acute lymphoblastic leukemia (ALL) is a disease of the blood system that manifests itself in the gingiva. This case report describes the early recognition of adolescent ALL through gingival swelling and pain as the initial clinical manifestation and recorded the 10-year follow-up process. After chemotherapy, the patient was cured. In the 8th year, the red, swollen and painful gingiva was relieved, no significant resorption of the alveolar bone was observed, and the periodontal condition was fully recovered two years after basic treatment. This case emphasizes the importance of dentists being vigilant for signs of systemic disease in the oral cavity and the role of long-term periodontal maintenance.</p>","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143415720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Crestal approach for repair of oroantral bone defects and subsequent implant placement.","authors":"Min Yang, Miriam Ting, Rodrigo Neiva, Jonathan Korostoff","doi":"10.1002/cap.10332","DOIUrl":"https://doi.org/10.1002/cap.10332","url":null,"abstract":"<p><strong>Background: </strong>Oroantral communication (OAC) can occur after a dental extraction. Occasionally, bony defects may persist despite successful soft tissue closure of the OAC. The absence of bone in these areas poses challenges for dental implant placement. This report describes a novel approach of vertical sinus elevation through the oroantral bony defect to address such scenarios.</p><p><strong>Methods: </strong>A 36-year-old male (Patient 1) and a 62-year-old female (Patient 2) presented with OACs in the first maxillary molar region. Vertical sinus elevation was achieved through the existing defect. This was followed by placement of corticocancellous bone allograft mixed with platelet-rich fibrin (PRF) in the space surrounded by the elevated sinus membrane that was then covered with a resorbable collagen membrane. Implants were placed 9 and 6 months after the sinus lift in Patient 1 and Patient 2, respectively.</p><p><strong>Results: </strong>In both cases, substantial radiographic bone fill of the oroantral bony defect was achieved allowing successful placement of dental implants. Following insertion of final restorations, the patients were satisfied with the esthetic outcomes and reported improved oral function.</p><p><strong>Conclusions: </strong>Vertical sinus elevation through residual bony oroantral defects in conjunction with placement of bone allograft mixed with PRF yields sufficient alveolar bone for subsequent placement of dental implants.</p><p><strong>Plain language summary: </strong>Bone defects secondary to oroantral communications resulting from dental extractions may persist despite successful soft tissue closure. Such oroantral communication (OAC) pose challenges for dental implant placement. This report describes a technique for repairing oroantral bony defects and subsequent placement of dental implants. Two patients presented with OACs in the first maxillary molar region. Vertical sinus elevation with corticocancellous bone allograft and platelet-rich fibrin, was achieved through the existing defect. Substantial radiographic bone fill of the oroantral bony defect was achieved and implants with final restorations were subsequently placed.</p><p><strong>Key points: </strong>Elevation of the sinus membrane through an existing crestal defect resulting from an OAC allows the clinician to successfully elevated the sinus membrane for bone augmentation allowing eventual placement of an implant. The approach allows the clinician to achieve this goal without preparing a second window through a more invasive lateral approach.</p>","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143415855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Polymethyl methacrylate-based bone cement using a prototype for gingival smile: A case report.","authors":"Biancca Rodriguez-Mannucci, Alberto Rios-Arango, Andrea Vergara-Buenaventura","doi":"10.1002/cap.10322","DOIUrl":"https://doi.org/10.1002/cap.10322","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The treatment of gummy smile (GS) with polymethyl methacrylate (PMMA)-based implants is suggested in specific cases such as those in which there is a lack of lip support due to a marked depression of the anterior maxillary process; however, it can be associated with certain complications related to the material and the surgical approach.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A patient with a GS of combined etiology was treated with clinical crown lengthening and lip repositioning surgery with placement of a PMMA-based bone cement implant to fill the subnasal depression. Surgical planning was performed using a 3-dimension resin-printed model to achieve an optimal fit of the PMMA implant to the geometry of the bone defect and to avoid any damage related to heat exposure from the polymerization process and any possible damage to the tooth roots with the fixation screws. In addition, the use of an antibiotic cement can help prevent any possible infection.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The patient reported edema and mild pain. After 5 months an increase in the length of the dental crowns, a reduction of the exposed gingiva to 1 mm and a new support of the upper lip were clinically observed. Cone-beam computed tomography showed proper PMMA implant fit.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The use of PMMA-based bone cement appears to be an effective technique for the treatment of cases of GS associated with hypermobile upper lip and maxillary subnasal depression. The use of a printed resin model avoids complications during curing of the material, such as high exothermic reactions and associated infections.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Key points: &lt;/strong&gt;Identification of the etiologic factors of gummy smile is fundamental to the treatment of gummy smile. Once the diagnosis is established, therapy focuses on the treatment of these factors, which may be single or combined. The use of a PMMA-based bone cement implant in conjunction with clinical crown lengthening surgery is an effective treatment option for the management of EGD related to upper lip hypermobility, passive altered eruption and, maxillary subnasal depression. A possible clinical dilemma could arise when considering some complications associated with the use of PMMA implants such as allergies or infections. However, the use of a 3D printed resin model facilitates handling and fitting outside the mouth by eliminating heat exposure from the polymerization of the cement and to avoid any possible damage to the tooth roots with the fixation screws. In addition, the use of an antibiotic cement can help prevent any possible infection.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Plain language summary: &lt;/strong&gt;The treatment of gummy smile will depend on its etiological factor. In some cases of combined etiology, the use of polymethyl methacrylate (PMMA) implants has been suggested, such as those in which there is a lack of lip support due to a marked depression of the maxillary anterior process; however, the use of","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advanced dental surgeries using fused filament fabrication and stereolithography printing: Case reports.","authors":"Jaewon Kim, Michael Danielak, Du-Hyeong Lee, Bandar Almaghrabi, Sebastiano Andreana, Jekita Kaenploy, Yousef Kareem, Fernando L Esteban Florez, Praveen R Arany","doi":"10.1002/cap.10344","DOIUrl":"https://doi.org/10.1002/cap.10344","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The widespread use of digital imaging can now be combined with additive three-dimensional (3D) printing, changing traditional clinical dentistry, especially in challenging cases. Visualizing the bone and soft tissue anatomy using computed tomography (CT) and intraoral scanning generated digital files that can be further processed for 3D printing. Among the popular 3D printing approaches, fused filament fabrication (FFF) and stereolithography (SLA) are broadly used due to their rapid production, precision, and ease of use.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The current case series outlines three challenging clinical scenarios where a combination of CT and intraoral scans were utilized for digital planning. FFF multicolor anatomical models and SLA surgical guides were produced using 3D printing technology. The first case outlines the utility of this approach to place the optimal surgical window at the lateral sinus lift with anticipated difficult access. In the second case, distinct sites for autogenous bone harvesting were identified while preserving critical adjacent structures with surgical simulation. Finally, the third case outlines this strategy for optimal surgical access to expose an impacted second premolar.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Both clinicians and patients benefited from the educational use of FFF‒SLA 3D-printed models, and all cases were successfully treated without complications.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;These cases demonstrate the significant utility of these digital technologies and rapid prototyping for improved pre-surgical planning, patient motivation, and didactic training that contribute to improved quality of clinical care.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Key points: &lt;/strong&gt;To the authors' knowledge, this is the first case reports employing both fused filament fabrication (FFF) and stereolithography (SLA) printing techniques in dental surgery. This innovative approach addresses a range of clinically challenging scenarios presented in this report. Computed tomography (CT) and intraoral scanning are essential for three-dimensional (3D) reconstruction. Specialized software is required to design the guide with precise specifications, and FFF and SLA printers are necessary for fabricating the 3D model. Three-dimensional reconstruction can be time-intensive, particularly when manual segmentation is necessary. Acquiring proficiency in the software may require additional time, and multicolor 3D printing also demands extended printing durations.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Plain language summary: &lt;/strong&gt;This study explores how digital imaging and three-dimensional (3D) printing can improve complex dental surgeries. Using tools such as computed tomography scans and intraoral scans, dentists can create detailed 3D models of a patient's bone and soft tissues. Two popular 3D printing methods-fused-filament fabrication (FFF) and stereolithography (SLA)-were used to make these models, which help with surgical planning. T","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Horizontal platelet-rich fibrin versus advanced platelet-rich fibrin plus in gingival recession management.","authors":"Kavitha Sridhar, Anupama Tadepalli, Harinath Parthasarathy, Priyanka K Cholan, Lakshmi Ramachandran","doi":"10.1002/cap.10342","DOIUrl":"https://doi.org/10.1002/cap.10342","url":null,"abstract":"<p><strong>Background: </strong>Newer generation platelet concentrates, such as advanced platelet-rich fibrin plus (A-PRF+) obtained following low-speed centrifugation concept and horizontal platelet-rich fibrin (H-PRF) obtained from swing out and bucket system, showed increased platelet entrapment and growth factor release in the in-vitro studies. This prospective study aimed to evaluate and compare the clinical outcomes of A-PRF+ and H-PRF membranes in the treatment of gingival recession defects. The objectives of this study were to compare the changes in the recession height (RH) and the mean root coverage percentage (MRC%) between and within the research groups.</p><p><strong>Methods: </strong>Forty-four systemically healthy patients diagnosed with 84 Cairo's RT 1 and RT 2 gingival recession defects in the maxillary anterior and premolars were randomly treated with a combination of the coronally advanced flap (CAF) and A-PRF+ membrane (n = 22 subjects) or H-PRF membrane (n = 22 subjects). Patients were reviewed at 3 and 6 months postoperatively. Parameters including RH, MRC%, complete root coverage (CRC), gingival thickness, keratinized tissue height, and root coverage esthetic scores were documented.</p><p><strong>Results: </strong>Both treatments resulted in a significant reduction in RH (p < 0.001). The CAF + A-PRF+ group demonstrated a reduction in RH from 2.47 ± 1.00 mm to 0.59 ± 0.52 mm and the MRC% was 76.33 ± 22.54%, at 6 months. In the CAF+H-PRF group, the mean RH decreased from 2.43 ± 1.01 mm to 0.38 ± 0.59 mm and the MRC% was 85.51 ± 19.87%. Three- and six-month intergroup analysis revealed statistically insignificant differences in the observed clinical parameters between the groups (p > 0.05).</p><p><strong>Conclusions: </strong>The study found that both CAF + H-PRF and CAF + A-PRF+ protocols resulted in similar clinical outcomes while treating maxillary gingival recession defects.</p><p><strong>Plain language summary: </strong>Numerous modifications have been proposed to improve the growth factor content in the platelet concentrates and thereby therapeutic potential. This study compared platelet-derived membranes obtained by two different spin protocols in the treatment of gum recession. Forty-four patients were treated with either platelet-derived membrane obtained by horizontal spin protocol (test group) or low-speed spin concept (control group). Both treatment methods resulted in satisfactory healing. At the end of 6 months, no differences were noted with regard to the changes in clinical measurements and root coverage percentage indicating similar clinical efficacy of both preparatory techniques.</p>","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Master Clinician Editorial.","authors":"Henry Takei, Jonathan H Do","doi":"10.1002/cap.10337","DOIUrl":"https://doi.org/10.1002/cap.10337","url":null,"abstract":"","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Apical horizontal incision with periosteum graft wall technique for periodontal regeneration: A case study.","authors":"Kazuhito Shiraishi, Lan-Lin Chiou, Takeshi Haga, Yusuke Hamada, Pierpaolo Cortellini","doi":"10.1002/cap.10339","DOIUrl":"https://doi.org/10.1002/cap.10339","url":null,"abstract":"<p><strong>Background: </strong>The periosteum consists of an outer fibrous layer and an inner cellular layer, where bone cells reside. Hence, it has been suggested that applying periosteum to a periodontal defect may help new bone formation. The purpose of this case study is to present the clinical and radiographic outcomes of a vestibular regenerative approach and the application of a connective tissue graft (CTG) with periosteum to improve the periodontal prognosis of a pathologically migrated hopeless tooth with an endo-periodontal lesion (EPL).</p><p><strong>Methods: </strong>A 35-year-old female presented with a hopeless tooth with EPL on #9. To preserve the papilla, a horizontal incision with two vertical releasing incisions was made on the buccal vestibule where the buccal bone was present. A CTG with periosteum was harvested from the tuberosity area. After applying enamel matrix derivative (EMD) and freeze-dried bone allograft (FDBA), the CTG was placed over the defect and stabilized with absorbable sutures. The flap was replaced and sutured, achieving primary closure and healing by primary intention.</p><p><strong>Results: </strong>Following regenerative procedure, a localized orthodontic treatment was applied. A minimal ridge resorption, shallow probing depth, and radiographic stability of periodontal bone level were observed.</p><p><strong>Conclusion: </strong>This case study shows the successful application of a multidisciplinary approach to save a hopeless tooth with severe bone destruction and a non-contained periodontal defect.</p><p><strong>Key points: </strong>Multi-disciplinary approach including endodontic, orthodontic, and periodontal regenerative procedure can improve the prognosis of natural teeth. It would be beneficial to maintain the blood supply to the crestal part of the flap with apical incision. Connective tissue graft with periosteum could enhance the healing potential when used in adjunct with periodontal regeneration.</p><p><strong>Plain language summary: </strong>The apical horizontal incision combined with periosteum graft could successfully save a tooth with severe bone destruction and a non-contained periodontal defect. The importance of wound stability on the papillae area was achieved with the vestibular approach with application of the room concept. This method would be beneficial to improve the periodontal prognosis of a severely periodontally compromised tooth.</p>","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Regenerative surgical therapy in a frequent cannabis consumer: A case study.","authors":"Carola B Bozal, Marina Sosa, Sofía Aguirre, Cristina Rodríguez, Mariano Adrados, Mariel Gómez, Hugo J Romanelli","doi":"10.1002/cap.10325","DOIUrl":"https://doi.org/10.1002/cap.10325","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;There is substantial evidence that smokers present a less favorable response following regenerative periodontal surgery. However, there are no reports to date on the response to regenerative procedures in chronic cannabis smokers. In the present case study, we discuss the periodontal outcomes of reparative and regenerative surgical treatment in a cannabis consumer patient with generalized stage III grade C periodontitis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods and results: &lt;/strong&gt;We report the case of a young adult cannabis consumer patient diagnosed with generalized stage III grade C periodontitis who had a probing depth (PD) of ≥ 4 at 18% of sites and of ≥ 7 mm at 12% of sites and radiographically confirmed generalized interproximal bone loss with horizontal and angular defects that reached the middle and apical third of the roots. An appropriate sequence of therapy based on the recommendations in the Clinical Practice Guideline (CPG) involving reparative and regenerative surgical procedures (steps 1-3) was followed. Clinical outcomes at 6 months included a decrease in PD of up to 7 mm and radiographic evidence of newly formed bone in the bony defects.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The present case study demonstrates the use of regenerative periodontal procedures as part of a stepwise treatment approach, with different interventions at each step, to successfully manage intrabony periodontal defects in a healthy young adult male cannabis consumer.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Key points: &lt;/strong&gt;Smoking is a well-documented dose-dependent risk factor for periodontal disease, with a demonstrated negative effect on periodontal therapy outcomes. However, the usefulness of regenerative periodontal therapy in cannabis smokers has not been established to date. This case presents new information in that it is the first report to show that appropriate periodontal treatment can stabilize the periodontal disease and that regenerative therapies were successful in healing intrabony periodontal defects in a healthy young adult cannabis user. The keys to successful management of this case are: -Attention to detail in all aspects of therapy. -Patient compliance as a co-therapist by maintaining effective plaque control. -Patient acceptance of supportive care recommendations. The primary limitations of this case study are: -The main limitation of this study is that a single clinical case study is too small to draw conclusions about regenerative treatment in patients who use cannabis. -The follow-up assessment times were not sufficient to determine the long-term success of regenerative surgery. -Patient compliance with oral hygiene recommendations and supportive care are key to achieving long-term success in regenerative therapy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Plain language summary: &lt;/strong&gt;Background: Smokers have a worse response to regenerative periodontal surgery. There are no reports on how cannabis smokers respond to regenerative procedures. This case study discuss","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical treatment for severe endodontic-periodontal lesion: A case report with 2-year follow-up.","authors":"Yoshitaka Nara, Lorenzo Tavelli, Shogo Maekawa","doi":"10.1002/cap.10341","DOIUrl":"https://doi.org/10.1002/cap.10341","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Various surgical techniques have recently been developed for periodontal tissue regeneration, especially those do not involve any incisions in the interdental papillae at the regeneration site. These techniques have significant advantages for obtaining clinical attachment gain with least amount of gingival recession, however, may also have disadvantages such as limited field of surgical view, difficulty in debridement, and limited access only from the buccal side. This case report addresses a 2-year follow-up with a novel surgical approach to achieve periodontal regeneration that overcomes these limitations: the flexible tunnel technique (FTT).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In a 66-year-old patient, in an enclosing infrabony defect extending to the root apex on the palatal side, which appeared to be an endodontic-periodontal lesion on tooth #5, four vertical incisions and a periosteal releasing incision were performed in order to make the interdental papillae easier to translocate over the abutment teeth, which led to obtain clearer operative field. After debridement, the enamel matrix derivative was applied to the root surface and the infrabony defect was filled with deproteinized bovine bone mineral. The flaps were relocated, and simple interrupted sutures were performed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;One year later, pocket closure and improvement of bone defects were observed without gingival recession. After confirmation with improved mobility, a full zirconia crown was placed. During 2-year follow-up, periodontal tissue was maintained well without any complication.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The FTT can be used to approach endodontic-periodontal lesions and infrabony defects extending to the root apex without incision of the interdental papillae.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Key points: &lt;/strong&gt;A more accessible tunnel technique can be performed by using four vertical incisions. If the tooth is abutment, interdental papillae can be flexible to translocate due to this tunnel technique with vertical incisions. Ensuring root surface debridement, application of regenerative materials, and wound stability are the keys to this regenerative procedure. The patient needs to understand the risks associated with the proposed periodontal regenerative surgery and the prognosis of tooth.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Plain language summary: &lt;/strong&gt;Various surgical techniques have been developed recently to help regenerate the tissues that support teeth, especially methods that avoid making cuts in the gum tissue between the teeth at the treatment site. However, these techniques may have some drawbacks, such as limited visibility during surgery, difficulty cleaning the area, and access only from the outer side of the teeth. This case report addresses a 2-year follow-up of a new surgical method aimed at overcoming these challenges: the flexible tunnel technique (FTT). In a deep bone defect extending to the tip of the tooth root on the roof ","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Master Clinician Editorial.","authors":"Robert Schallhorn, Rachel Schallhorn","doi":"10.1002/cap.10336","DOIUrl":"https://doi.org/10.1002/cap.10336","url":null,"abstract":"","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}